Q and A


If I have unprotected sex with other HIV positive people will I get resistance?


I’m a HIV positive gay male aged 27, infected and diagnosed in 2007. I am currently healthy with a CD4 count of 560 and a viral load of 35,000 and not yet on any medication.

I’ve been scared to sleep with other positive men through fear of catching treatment resistant strains or worse. I am a passive partner and I’m afraid my question does relate to unprotected sex. I am aware of the risks associated therein, afterall it got me in this situation!

I would like to know if I were to sleep with a HIV positive guy, is it better for me if he is on meds and undetectable or would that put me more at risk of developing resistance?

Now I can ‘sero-sort’ I’d like to know what’s likely to be the safest way to prevent my situation getting any worse, be it developing drug resistance, superinfection or other hard to treat infections?

I am also immunised against hepatitis B. Am I truly safe against this if I were to unknowingly come into contact with it?

Many thanks


Thank you for your question.

The answer I am giving may seem a little long but is related to lots of people in a similar situation to yourself so I have tried to include all the relevant information.

Some people loose their libido after they find out they are HIV positive or are afraid to have unprotected sex and so do not want to have sex at all. This can affect their quality of life and make them feel depressed. Sex is an important part of life for most people, and HIV complicates this, but it should not stop you having a healthy sex life. It wasn’t clear whether you have stopped having sex altogether, or just that you are worried about other HIV-positive men.

The best answer to your question is less dependent on your partners status though, but on being able to have a discussion about the issues your raised – about resistance, treatment history and STIs.

Most HIV positive people will have had a resistance test and will know if they are resistant to any medication. Have you had a resistance test? If not then talk to your HIV doctor about getting one. Your potential risk to other HIV-positive partners is as important as their risk to you.

It is not known whether re-infection itself is an issue. If neither of you have resistance, the only risk is STIs. It is a problem though if resistance is involved. If either you or your partner have different resistance, then reinfection would pass the new resistance. The more resistance, the more serious the impact on future treatment choices. Drug resistance is an important reason to continue using condoms and with multidrug resistance this is essential.

Most HIV-positive people are very happy to talk about how they are doing or to support someone else who is new to this. This is where we can all support each other.

Viral load relates to the risk of reinfection, and when it is undetectable the risk of re-infection is likely to be very low, even if someone has a partially-resistant strain of HIV.

If you are having sex with someone who is HIV positive and not on treatment then providing that neither of you are resistant to medication there is likely to be little risk from re-infection. If they are resistant to some medication you would need to find out which medication they are resistant to, and decide if you would be happy to lose the choice of those drugs.

This really means that if having sex without condoms is important, you need to know a bit about your partners’ current treatment and history. This isn’t as difficult as it sounds. If you are both positive, then you both will feel better if you can make an informed choice about your risks. It is very common for people to feel that getting HIV is enough. Saying you don’t want more health problems upfront is fine, and shows respect for yourself. Sero-sorting when both partners are HIV-positive can be a very important aspect of life, while coming to terms with other ways that HIV has affected your.

Any unprotected sex obviously carries a risk of infection with other sexually transmitted infections (STI). Co-infection with hepatitis C is a real risk amongst HIV positive gay men, and there is no vaccine. Your HIV clinic should test for hepatitis C and other STIs annually, or as necessary.

Your hepatitis B vaccine will protect you from HepB. You should also have a vaccine for hepatitis A. The level of immunity you have for hepatitis A and hepatitis B should also be checked by you HIV clinic annualy. Some people do not need booster vaccinations for 5-10 years after the initial dose.

For any further information or if you need any support then please do not hesitate to contact us on the treatment information helpline (Mon-Wed 12-4pm)

Information on this website is provided by treatment advocates and offered as a guide only. Decisions about your treatment should always be taken in consultation with your doctor.


  1. Lisa Thorley

    Hi tiisetso,

    How are you doing since you started meds? Is you CD4 recovering well? And what is your viral load?

    Because your boyfriend is having sex with other women and may not be using condoms, there is a chance that he may contract other STIs. If this happens and you have sex without a condom, you may contract these STIs. This is unlikely to affect your HIV. However, it could affect your health. This is something to be cautious about.

    With regards to your boyfriend not adhering to his medication, this could cause resistance to happen. This may lead to reinfection.

  2. tiisetso

    I found out that I’m HIV positve in 2012. I went into denial and deiced not to take treatment hoping that the result would change one day. However, early last year, 2016 I started to get sick and went to the clinic and re did the test. It turns out that I was still positive, and my CD4 had dropped drastically. I decided to make peace with it and began taking meds .

    Now my worry is that my boyfriend was the first to take ARV’s now he doesn’t take them daily like he used to, he thinks he is strong. He is sleeping with other women and I’m not sure if he uses condoms. Will this affect me?

  3. Lisa Thorley

    Hi Thabo,

    You may wish to use a condom when having sex with your wife until you’ve finished PEP and also done your HIV tests.

  4. Thabo

    I like to ask, I’ve got a wife we both HIV negative I had one night with someone who is HIV positive the condom burst while having sex. I went to the Dr now am drinking Trivenz,can I have sex with my wife while I am still on treatment?

  5. Lisa Thorley

    Hi Klass,

    Taking tribuss when not knowing if you are HIV positive or not is dangerous. You could be risking your health when not necessary. You need to have a HIV test done. If you are positive, you will be prescribed free ARVS, as they are free in South Africa.

    Splitting doses with your wife could also be seriously affecting her health because ARVs are supposed to be taken daily. Though there is some research that states that you can take tribuss less.

    With regards to why you are losing weight, I don’t know. But if you are HIV positive and have a low CD4 count this could be the reason. You having sex with your wife will neither make her gain weight, or you lose it.

  6. Klaas

    I have not tested, but find my wife’s been on tribuss since 2015. I recently started joining her after we where both treated for an STD. What worries me is, she gains weight while I loose it. Luckily she has tested, but I haven’t. I am though using tribuss as she is sahring her packet, since I am not employed.

    I have lot of appetite and we are still sexually active, but without protection will this be the cause of my weight loss or not?


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